Devices for grasping free suture ends during surgical procedures are well known in the art. In one such device, an elongated element is provided. This element has a flexible, closed loop at one of its ends. The elongate element is telescopically mounted inside a hollow shaft so that the loop can be alternately withdrawn into, or projected out of, the distal end of the shaft.
In use, this device is first set so that its loop is retracted into the shaft. Then the device is manipulated so that the distal end of the shaft is brought into the vicinity of a free end of the suture which is to be grasped. The loop then is projected out of the distal end of the shaft. The device is thereafter further manipulated so that the free end of the suture which is to be grasped extends through the loop. Finally, the loop surrounding the suture is retracted back into the shaft, thereby grasping the suture and holding it tightly against the distal end of the shaft.
While devices of the type described above work for their intended purpose, they also have several drawbacks. For example, it is often difficult (or impossible) to conveniently access a free end of a length of suture, even in those cases where some intermediate portion of the suture has been located. This is particularly true in closed surgeries where visibility is frequently quite limited and the available space at the surgical site is often restricted.
Furthermore, in many surgical procedures suture needs to be laced one or more times through one or more layers of tissue. Conventionally, such suturing is accomplished by attaching a needle to at least one free end of the suture. This needle is then manipulated using a needle holder so as to pass the suture through the tissue. Thereafter, a grasping device such as the one described above is used to snare a free suture end (or ends) for further manipulation or tying.
The need to use a needle and needle holder to pass the suture through the tissue, and the need to use a separate grasping device to complete the suturing operation, can be inconvenient and cumbersome. This is particularly true in closed surgical procedures where the surgeon must operate through a small passageway leading from the skin of the patient to an internal surgical site. In such situations, the surgeon's visual and physical access to the surgical site is generally quite limited.